A simple method to estimate flow restriction for dual ventilation of dissimilar patients: The BathRC model
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Abstract
With large numbers of COVID-19 patients requiring mechanical ventilation and ventilators possibly being in short supply, in extremis two patients may have to share one ventilator. Careful matching of patient ventilation requirements is necessary. However, good matching is difficult to achieve as lung characteristics can have a wide range and may vary over time. Adding flow restriction to the flow path between ventilator and patient gives the opportunity to control the airway pressure and hence flow and volume individually for each patient. This study aimed to create and validate a simple model for calculating required flow restriction.
Methods and findings
We created a simple linear resistance-compliance model, termed the BathRC model, of the ventilator tubing system and lung allowing direct calculation of the relationships between pressures, volumes, and required flow restriction. Experimental measurements were made for parameter determination and validation using a clinical ventilator connected to two test lungs. For validation, differing amounts of restriction were introduced into the ventilator circuit. The BathRC model was able to predict tidal lung volumes with a mean error of 4% (min:1.2%, max:9.3%).
Conclusion
We present a simple model validated model that can be used to estimate required flow restriction for dual patient ventilation. The BathRC model is freely available; this tool is provided to demonstrate that flow restriction can be readily estimated.
Models and data are available at DOI 10.15125/BATH-00816 .
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SciScore for 10.1101/2020.04.12.20062497: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources In this mode the adjustable settings are: In Pressure Control Mode, the ventilator effectively controls the driving pressure to transition between PEEP and Pinsp+PEEP as quickly as possible at the required switching times; any limits or triggers which might alter this profile need to be disabled for dual patient use. Pinsp+PEEPsuggested: NoneCustom functions (MATLAB 2019b, The Mathworks Inc., Natick, MA, USA) were used to co-register the data collected on the two computers for each experiment. MATLABsuggested: (MATLAB, RRID:SCR_001622)Results from OddPub: Thank you for sharing your code.
Re…SciScore for 10.1101/2020.04.12.20062497: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources In this mode the adjustable settings are: In Pressure Control Mode, the ventilator effectively controls the driving pressure to transition between PEEP and Pinsp+PEEP as quickly as possible at the required switching times; any limits or triggers which might alter this profile need to be disabled for dual patient use. Pinsp+PEEPsuggested: NoneCustom functions (MATLAB 2019b, The Mathworks Inc., Natick, MA, USA) were used to co-register the data collected on the two computers for each experiment. MATLABsuggested: (MATLAB, RRID:SCR_001622)Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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